A report published in the February 1, 2006 issue of the journal Obstetrics & Gynecology revealed that extracts of the herbs St John’s wort and black cohosh were helpful in alleviating menopausal complaints including depression among a group of postmenopausal women. The majority of women report a variety of unpleasant symptoms during the menopausal years, and five percent report these symptoms as severe.

In the current study, 301 women received an extract of St John’s wort with black cohosh extract, or a placebo for 16 weeks. Participants were administered two tablets twice per day for the first half of the study, and one tablet twice daily for the remainder of the trial. Menopausal symptoms and psychological complaints were rated before treatment, at eight weeks, and at the end of the trial.

The Berlin researchers found a reduction in menopausal complaints of 50 percent for the treatment group and 19.6 for those who received the placebo. Hot flashes, urogenital symptoms, psychological and physical complaints all declined among those who received the herbal combination. In a separate test that rated depression, women who received St John’s wort and black cohosh experienced a decline of 41.8 percent, while a reduction of 12.7 percent occurred among women who received the placebo. Seventy-nine percent of those who received the extracts versus 14.9 percent of the placebo group judged the efficacy of their treatment as being moderate to very good at the end of the trial.

In their discussion of the findings, the authors observed that the addition of St John’s wort to black cohosh improved psychological symptoms compared to those associated with black cohosh alone in previous research. While antidepressant drugs have been tried for menopausal symptoms, they have not been found to be as effective as hormone therapy and can have significant dose-related adverse events. As the number of adverse events reported in this study did not differ between the treatment and placebo groups, a combination of St John’s wort and black cohosh may be an effective alternative for the treatment of menopausal complaints.

For most women, menopause is known chiefly through its side effects. Up to 85 percent of Western women experience menopausal symptoms, including hot flashes, night sweats, disturbed sleep, fatigue, and related psychological changes, such as depression and anxiety (Burd et al 2001; Mahady et al 2002; Philp 2003; Soares et al 2003). Physical changes include urinary tract atrophy, vaginal atrophy and dryness with discomfort during sexual intercourse (Burger 2001; Coope 1996; Griffith 2004). These uncomfortable symptoms can last up to five years, with an average duration of two to three years (Samsioe 1995).

In addition to hormone restoration therapy, many supplements have been shown to suppress the symptoms of menopause and hormone loss. Folk and traditional healing therapies have successfully and safely used herbal medicines to treat gynecologic problems for more than 100 years (Hardy 2000; Mahady et al 2002). These herbal medicines include the following:

Black cohosh. Native American Indians have used black cohosh as a traditional medicine for many years, and Koreans have used it to treat pain and inflammation (Huntley 2004; Kim et al 2004; McKenna et al 2001). Today, it is used primarily for the treatment of menopausal symptoms, such as hot flashes, and menopausal depression and anxiety (Kennelly et al 2002). Black cohosh has also been used to treat younger women who have surgically induced hormonal deficits due to hysterectomy or ovariectomy and for menstrual disorders ( McKenna et al 2001). It is effective for reducing hot flashes, night sweats, fatigue, and insomnia (Kronenberg et al 2002; Philp 2003; Pockaj et al 2004).

In an attempt to provide aging women with the multiple health effects of estrogen without side effects, scientists have discovered plant extracts with estrogenic activity (phytoestrogens).

Natural Estrogen is one answer to concerns about the risks of synthetic estrogen replacement. A review of the published literature reveals some interesting findings about how plant-derived estrogens can provide safe and effective female sex hormone replacement therapy, and help provide support for such menopausal symptoms as hot flashes.

St. John’s Wort (hypericin extract) is a weak inhibitor of monoamine oxidase A, which may destroy dopamine in the brain and lead to low spirits. Flavonoids, hypericin, and pseudohypericin are the constituents thought to be associated with the benefits of St. John’s Wort. In particular, hypericin appears to be the active ingredient.

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